Evidence map›Paper›PMID 41895806›Full record

ArticleBMJ open2026

Platform trial of smartphone-based cognitive-behavioural therapy (CBT) for depressive symptoms among people with no or subthreshold depression: a protocol for the Best, Efficient and Affordable Training in Resilience in Constant Evolution (BEATRICE) platform trial.

Toshi A Furukawa, Hisashi Noma, Masahiro Kojima, Aran Tajika, Rie Toyomoto, Masatsugu Sakata, Yan Luo, Kosuke Inoue, Masaru Horikoshi, Tatsuo Akechi and 11 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Toshi A FurukawaOffice of Institutional Advancement and Communications, Kyoto University, Kyoto, Japan furukawa@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0003-2159-3776
Hisashi NomaDepartment of Interdisciplinary Statistical Mathematics, The Institute of Statistical Mathematics, Tachikawa, Japan.ORCID http://orcid.org/0000-0002-2520-9949
Masahiro KojimaDepartment of Data Science for Business Innovation, Chuo University, Tokyo, Japan.ORCID http://orcid.org/0000-0003-0867-7692
Aran TajikaDepartment of Health Promotion and Behavioral Sciences, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0003-3926-8867
Rie ToyomotoDepartment of Health Promotion and Behavioral Sciences, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0003-1125-3145
Masatsugu SakataDepartment of Neurodevelopmental Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.ORCID http://orcid.org/0000-0002-5358-5263
Yan LuoDepartment of Next-Generation Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan.ORCID http://orcid.org/0000-0002-5271-5126
Kosuke InoueDepartment of Health Promotion and Behavioral Sciences, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0001-6131-9785
Masaru HorikoshiMusashino University, Tokyo, Japan.ORCID http://orcid.org/0000-0001-9336-8813
Tatsuo AkechiDepartment of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.ORCID http://orcid.org/0000-0003-1100-7518
Norito KawakamiDepartment of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID http://orcid.org/0000-0003-1080-2720
Naoki KondoDepartment of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0002-6425-6844
Takeo NakayamaDepartment of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.ORCID http://orcid.org/0000-0002-7918-6252
Shingo FukumaDepartment of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0002-8379-8761
Helen ChristensenBlack Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0003-0435-2065
Alexis WhittonBlack Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-7944-2172
Wolfgang LutzDepartment of Psychology, Trier University, Trier, Germany.ORCID http://orcid.org/0000-0002-5141-3847
Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam, Vrije Universiteit Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-5497-2743
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0003-4831-2305
James WasonPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID http://orcid.org/0000-0002-4691-126X
Inbal Nahum-ShaniInstitute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0001-6138-9089

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe global burden of depression continues to rise despite evidence that prevention is feasible and cost-effective. Building on the Resilience Enhancement with Smartphone in Living ENvironmenTs (RESiLIENT) randomised controlled trial, the Best, Efficient and Affordable Training in Resilience in Constant Evolution (BEATRICE) platform trial evaluates and optimises smartphone-delivered cognitive-behavioural therapy (CBT) for adults with no to subthreshold depression. The primary objective is to minimise the Total Burden of Depression, measured by the integral of weekly to monthly Patient Health Questionnaire-8 (PHQ-8) scores over 12 months, through a living, adaptive platform trial that sequentially tests multiple clinical questions and personalised algorithms. METHODS AND ANALYSIS: BEATRICE is a nationwide, digitally centralised, multi-arm platform trial conducted via the 'Resilience Training App'. Eligible participants are adults (aged ≥18 years) with PHQ-8 ≤14, fluent in Japanese, owning a smartphone and not currently receiving mental health treatment. Recruitment takes place through health-insurance associations, companies, municipalities and online outreach. Participants are randomised centrally to CBT skill modules-behavioural activation, assertion training, behaviour therapy for insomnia, cognitive restructuringor problem-solving-delivered alone or in combination. Assessments are open-label and completed digitally by self-reports.The initial list of clinical questions to be examined in this platform trial includes: external validity of the personalised and optimised algorithm for first-line interventions, strategies to help individuals not on track during initial weeks, second-line interventions at 6 months, development of super-personalised and optimised therapy algorithm, that is, longitudinally personalised and optimised in response to individuals' responses after the first-line assignment. The primary outcomes, sample sizes and statistical analyses differ depending on the clinical question addressed within the platform trial. ETHICS AND DISSEMINATION: Approved by the Ethics Committee of Kyoto University Graduate School of Medicine (C1733). Results will be disseminated via peer-reviewed publications, conferences and public reports. TRIAL REGISTRATION NUMBER: UMIN000058696.

Indexed as

Cognitive Behavioral TherapyDepressionSmartphoneAdultHumansMobile ApplicationsRandomized Controlled Trials as TopicResilience, PsychologicalCognitive-behavioural therapyDepressionPlatform trialPreventionSmartphone

Identifiers

PMID41895806
PMCPMC13034358

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.